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    Tuesday, December 26, 2006

    Odds and Ends: Blogging has been light, even by my standards, due to family and work obligations and their resulting fatigue. But oh, so much has happened.

    On the upside, diabetes was cured. (In mice. Maybe.)

    On the downside, the Palestinian physician and Bulgarian nurses who were accused of infecting Libyan children with HIV have been sentenced to death. National Review Online's David Pryce Jones says such shenanigans are not new:

    A striking precedent is to be found in a book published in 1974, The private life of Islam, by Ian Young, an Englishman. Young had worked as a junior doctor in an Algerian hospital, and several of his colleagues were Bulgarian, sent to Algeria out of Communist solidarity with the Third World, as was the fashion at that time. The standards of medicine were appalling. Simple hygiene was absent. Young refers continually to the ants all over the place. There were tragically unnecessary deaths. The Supervisor was a total ignoramus, appointed because he had played a political role in the war to gain independence. Finally Young could stand no more bad, and often lethal, medicine, and complained. The Supervisor’s response was to lose his temper, and grapple with him physically, while beginning to rant about “white-coated saboteurs passing their hands from vagina to vagina, infecting my heroic people with syphilis.” Finally he gave the order, “leave this hospital immediately! Leave this country!” More than just ignorant, the Supervisor indeed sounds insane, as does the court in Libya now – but there is a logic to it.

    Young’s experience was an early example of the cultural clash now pre-occupying the world. That Algerian Supervisor had none of the qualifications needed to run his hospital, and he was excusing himself by blaming others for his defects. It’s the same in the Libyan example. AIDS has replaced syphilis on the charge sheet, but the refusal to face reality remains constant. Westerners are to be held responsible for the bad things Arabs and Muslims do, although this involves inventing conspiracies as wild as they are ludicrous. This mind-set conditions Islamist anti-Westernism. The condemned six in Libya are really victims of a very sad and debilitating inferiority complex which neither pity nor protest in the West can do much to change.

    Outside observers say that the same mentality is happening in Libya:

    The HIV outbreak at Al-Fateh Children's Hospital in Benghazi, Libya, that peaked in 1998 has been studied in detail by international experts, who have pored over patient charts, tested hundreds of blood samples to characterize the virus, and observed patient care activities at the hospital. All have concluded that the outbreak was nosocomial, resulting from the reuse of contaminated medical equipment. The efforts to understand the outbreak include a site visit by the World Health Organization (WHO) conducted in December 1998 and January 1999 that resulted in a 1999 report, as well as an investigation by Colizzi and Luc Montagnier,1 a codiscoverer of HIV, who were hired by the Libyan government, were given broad access to the hospital and patients, and completed their report in March 2003.

    ...Some of the evidence suggesting that the foreign workers are innocent comes in the form of two published molecular analyses of blood samples from the children, which demonstrated remarkable similarity among the strains of HIV-1 in all the children and revealed that the majority were coinfected with hepatitis C virus (HCV) but that the HCV strains varied.2,3 This diversity of strains suggests that the hospital has a history of poor infection control, since children become infected with HCV primarily during medical procedures. In addition, according to the report by Colizzi and Montagnier, genetic analysis of blood samples from children who were last admitted to the hospital in 1997 detected the presence of HIV RNA — the same unusual virus type found in the rest of the children — indicating that the virus was in the hospital before the guest workers arrived.

    Moreover, in visits to the hospital, both the WHO team and Colizzi found that syringes and other types of medical equipment that could retain infected blood were being routinely reused. Infusions of albumin, an unscreened blood product, were commonly used if a child looked weak, and the bottle and tubing were often used for more than one child.

    It is truly a shame when a hospital's physicians, nurses, and administrators are incapable of recognizing harmful policies. It's a tragedy that they instead take aim at scapegoats:

    In the first trial, a panel of judges set aside this scientific evidence in favor of a dramatic cloak-and-dagger scenario based on testimony by Libyans who said they had witnessed the nurses hoarding vials of HIV-infected blood; the testimony was bolstered by confessions that the nurses have since said were elicited by torture. A panel of Libyan doctors filed a counterreport,4 which, according to Montagnier, "was filled with basic scientific errors." For example, it concluded that the virus was "genetically altered" (and therefore intentionally created) because laboratory analysis had shown it to be a "recombinant" strain of HIV. But though the strain, CRF02-AG, had not been previously reported, it resembles and is thought to be a natural mutation of a strain that is common in central Africa.

    Similarly, the Libyan doctors concluded that the infections must have been deliberate because the infection rate was "too high" for nosocomial transmission, which, they argued (baselessly), could account only for rates below 3 cases per 1000 patients. Because of unsanitary practices, infection rates in Benghazi were indeed extraordinarily high, Western experts agreed. The HIV outbreak was, according to a 2001 article, "the largest documented outbreak of nosocomial transmission" of HIV. Although the exact figures vary, Libyan authorities now list more than 400 cases associated with the cluster, including 2 in nurses who worked at the hospital and at least 12 in mothers of the affected children.

    ...Indeed, the 200-page verdict from the first trial reads, says Colizzi, "like a bad spy film," laying out a sinister official theory of how these nurses brought AIDS to Benghazi. One nurse, the court decision says, masterminded the plan to spread HIV, storing the virus at her home in 24 green-topped blood-culture bottles. She lured the Palestinian doctor to participate in her scheme with the promise of a Bulgarian wife and $500,000 in a Swiss bank account. According to court documents, witnesses said the project was "prepared by Israeli Intelligence for political reasons and to start commotion" in Libya. The nurse supposedly carried out the plot on behalf of two English-speaking intermediaries named John and Adel, who supplied the virus. As corroborating physical evidence, investigators could point only to five "plasma bottles" purportedly found in the nurse's home, two of which they said had been shown to contain HIV. Colizzi and Montagnier examined the Western blots used and called them ambiguous. When they asked for the bottles so they could conduct their own analysis, the request was not granted.

    God help the Libyans. They certainly don't appear to be capable of helping themselves.

    posted by Sydney on 12/26/2006 08:22:00 AM 1 comments


    Where is the Humanity ?

    I must admit here that without reviewing the literature, including the results of expert analyses coupled with my personal experiences from Libya, I would not have any reasonable doubts that health workers at Al-Fateh Hospital in Benghazi should be blamed. Perhaps it should also be mentioned, that if the unsafe practices that may facilitate HIV transmission were really excluded then the conspiracy theories of AIDS should seriously be considered and investigated. In fact, there are a number of theories about AIDS which make claims about the origin and/or nature of the (HIV) and AIDS that differ radically from mainstream beliefs. These theories range from claims that HIV is not the principal cause, to suggestions that AIDS was the inadvertent result of medical experiments, to claims that HIV was deliberately created.

    Nevertheless, available evidence speaks in favor of the view that Libyan government wanted to deflect public outrage by accusing foreigners of committing a horrific crime -- rather than acknowledging the negligence of Libya's health system and prosecuting responsible individuals including all members of the management and the administrative staff of the al-Fateh hospital. In addition, Libyan government may be trying to blackmail European countries, offering to "pardon" the medics in exchange for billions of dollars in "compensation". Of course it cannot be excluded that the personnel may share part of responsibility, in using or accepting incorrect hygienic practices, but it does not mean a deliberate action of poisoning children.

    It is worth remembering in this regard that the article published in November 1998 in the Libyan magazine “La” mentioned that most parents were not informed that their children had been infected with HIV, the children were treated as if they were not ill at all and this led to the spread of the disease!!! Furthermore, the article clearly indicated the failings of the Benghazi children's hospital, viz. shortage of single-use products, repeated use of disposable instruments, lack of HIV tests, and failure to comply with standards of hygiene. The authorities typically banned the publication and had all the copies of the magazine seized. The answer why they won't bring the article to the attention of the Libyans was mentioned above.

    Finally, I would like to remind Libyan authorities one remarkable quote from Mu'ammar al-Qadhafi's Green Book condemning the toleration of boxing in sports, that caught my eye: "The more the people become civilized and sophisticated, the more they are able to ward off both the performance and the encouragement of these practices." I would therefore expect that the Libyan government, instead of scapegoating foreign medical professionals of doubtful accusations from conducting illegal vaccine trial or bio-terrorism orchestrated by the CIA and Israel's Mossad, rationally and humanly admit the overwhelming evidence that Benghazi hospital practiced poor hygiene and that underestimation of preventive practices in the country, led to the spread of HIV-1 and other blood born infections. I also guess they finally realized that political and religious attitudes toward AIDS should not divert attention from effective policies to prevent and combat it and that waiting to intervene can be very costly and very risky.


    Pijak MR. The roots of HIV/AIDS epidemics in Libya. Available at: http://scienceblogs.com/authority/2006/12/the_tripoli_six_and_the_scient.php

    Pijak MR. One more reader responds to "boxing should be banned in civilized countries--round 4". MedGenMed. 2005 Oct 14;7(4):12.

    Idris al-Mismari and Faraj al-'Arabi on AIDS cases among Benghazi children., published in Laa Magazine, Issue No. 78, November 1998, pp. 18-21. Available at: http://members.tripod.com/~sijill/hiv/hiv.htm

    Cantwell A. The Secret Origins of AIDS: Facts, Fallacies & Conspiracy Theories. New Dawn magazine. http://www.newdawnmagazine.com/Article/The_Secret_Origins_of_AIDS.html

    AIDS conspiracy theories. Wikipedia, the free encyclopedia. http://en.wikipedia.org/wiki/AIDS_conspiracy_theories

    By Anonymous Anonymous, at 4:15 PM  

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